Healthcare Provider Details

I. General information

NPI: 1861500308
Provider Name (Legal Business Name): SADA OKUMURA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 03/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 S KING ST
HONOLULU HI
96813-3009
US

IV. Provider business mailing address

888 S KING ST STRAUB DEPARTMENT OF NEUROLOGY
HONOLULU HI
96813-3097
US

V. Phone/Fax

Practice location:
  • Phone: 808-522-4000
  • Fax: 808-522-4377
Mailing address:
  • Phone: 808-522-4000
  • Fax: 808-522-4377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberMD-4570
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: